MEDICARE: LIAM SUPPORT SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	106S00000X	Behavior Technician
2	251E00000X	Home Health Agency
3	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326558438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIAM SUPPORT SERVICES LLC

Provider Business Mailing Address
First Line	:	12260 SW 8TH ST STE 156
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-1508
Country	:	US
Telephone Number	:	786-332-4326
Fax Number	:	786-558-9667

Provider Business Practice Location Address
First Line	:	12260 SW 8TH ST STE 156
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-1508
Country	:	US
Telephone Number	:	786-332-4326
Fax Number	:	786-558-9667

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARTHA AGRA
Credential	:
Telephone Number	:	305-905-6005

Provider Enumeration Date	:	10/03/2017
Last Update Date	:	03/30/2022

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Directions to “LIAM SUPPORT SERVICES LLC ” Practice Location

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